Peripаrtal cardiomyopathy in multiple pregnancy: clinical observation

• Nana K. Tetruashvili
• Runikhina Nadezhda K.
• Ostapenko V.S.
• Sharashkina N.V.
• T.V. Kirsanova
• G.A. Elenshleger

Abstract

Peripаrtal cardiomyopathy is a rare but serious disease that develops in late pregnancy or shortly after birth and manifest with symptoms of heart failure. Risk factors for its development include multiple pregnancy, hypertension and preeclampsia, prolonged treatment with β-adrenergic agonists, African American ethnicity. Delayed diagnosis leads to the postponement of treatment, severe complications development and associated with high maternal and perinatal mortality. The key diagnose method is echocardiography, which allows to identify systolic left ventricular dysfunction. The most effective combination for the treatment of patients with peripаrtal cardiomyopathy is the combination of β-adrenergic blocking agents and angiotensine transforming enzyme inhibitors. The effectiveness of bromocriptine therapy has been observed experimentally, but it is necessary to accumulate more clinical material and provide an evidence base for a final conclusion and recommendations for its use formation. Clinical case of peripаrtal cardiomyopathy in women with multiple pregnancies shows the potential severity of the disease, dangerous trend of symptoms increasing and differential diagnosis and therapeutic regimen selection complexity.

Keywords:multiple pregnancy, heart failure, peripаrtal cardiomyopathy, bromocriptine

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